Wei Cai

307 Hospital of the Chinese People's Liberation Army, Peping, Beijing, China

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Publications (24)33.82 Total impact

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    ABSTRACT: Objectives To evaluate renorrhaphy techniques and to analyze surgical outcomes in retroperitoneal laparoscopic partial nephrectomy.MethodsA retrospective study from January 2008 to December 2011 analyzed 526 patients with renal tumors in whom renorrhaphy was changed from one layer, interrupted, figure-of-eight (n = 228) suture to two layers, continuous, unknotted (n = 298) suture. All procedures were carried out by the same laparoscopic surgeon (XZ). Patient demographics, tumor characteristics, operative outcomes and perioperative renal function were compared.ResultsMedian follow up for one layer, interrupted, figure-of-eight suture and two layers, continuous, unknotted suture was 31 and 28 months, respectively. The two layers, continuous, unknotted suture group had shorter warm ischemia time (P = 0.021), faster removal of Jackson-Pratt drains (P = 0.029) and shorter hospital stay (P = 0.037) than the one layer, interrupted, figure-of-eight suture group. There was a trend towards a better preservation of glomerular filtration rates in the two layers, continuous, unknotted suture group (P = 0.045). In a multivariable model, the two layers, continuous, unknotted suture technique was a statistically significant independent predictor of warm ischemia time (P = 0.01), hospital stay (P = 0.001) and estimated glomerular filtration rates (P = 0.043).Conclusions Two layers, continuous, unknotted suture renorrhaphy allows better outcomes than one layer, interrupted, figure-of-eight suture renorrhaphy in retroperitoneal laparoscopic partial nephrectomy. A longer clinical follow-up evaluation is warranted.
    International Journal of Urology 05/2014; · 1.73 Impact Factor
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    ABSTRACT: To verify the feasibility and safety of retroperitoneal laparoendoscopic single-site radical nephrectomy and assess the value of our proposed approach to search for renal artery.
    International Journal of Clinical and Experimental Medicine 01/2014; 7(7):1752-6. · 1.42 Impact Factor
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    ABSTRACT: Objectives: To investigate the use of a flexible instrument platform in performing single-port laparoscopic retroperitoneal urologic surgeries and to verify the safety and feasibility of these surgeries. Methods: The homemade instrument platform consisted of two control loops and a powder-free surgical glove to form multichannels. 56 patients underwent this kind of single-port surgery for different urologic diseases, including radical nephrectomy in 31 patients, nephroureterectomy in 7 patients, partial nephrectomy in 8 patients, living donor nephrectomy in 4 patients, adrenalectomy in 3 patients, renal cyst surgery in 2 patients and ureterolithotomy in 1 patient. Results: All surgeries were completed successfully with no switch to conventional laparoscopic or open surgery. The mean hospital stay was 13.13 days (range 6-36). All patients were satisfied without major complications. Conclusions: Retroperitoneal laparoendoscopic single-site surgery using our cost-effective homemade instrument platform appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urologic surgery.
    Urologia Internationalis 06/2013; · 1.07 Impact Factor
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    ABSTRACT: The aim of this study was to validate the advantages of the intrafascial nerve-sparing technique compared with the interfascial nerve-sparing technique in extraperitoneal laparoscopic radical prostatectomy. From March 2010 to August 2011, 65 patients with localized prostate cancer (PCa) underwent bilateral intrafascial nerve-sparing extraperitoneal laparoscopic radical prostatectomy. These patients were matched in a 2∶1 ratio to 130 patients with localized PCa who had undergone bilateral interfascial nerve-sparing extraperitoneal laparoscopic radical prostatectomy between January 2008 and August 2011. Operative data and oncological and functional results of both groups were compared. There was no difference in operative data, pathological stages and overall rates of positive surgical margins between the groups. There were 9 and 13 patients lost to follow-up in the intrafascial group and interfascial group, respectively. The intrafascial technique provided earlier recovery of continence at both 3 and 6 months than the interfascial technique. Equal results in terms of continence were found in both groups at 12 months. Better rates of potency at 6 months and 12 months were found in younger patients (age ≤65 years) and overall patients who had undergone the intrafascial nerve-sparing extraperitoneal laparoscopic radical prostatectomy. Biochemical progression-free survival rates 1 year postoperatively were similar in both groups. Using strict indications, compared with the interfascial nerve-sparing technique, the intrafascial technique provided similar operative outcomes and short-term oncological results, quicker recovery of continence and better potency. The intrafascial nerve-sparing technique is recommended as a preferred approach for young PCa patients who are clinical stages cT1 to cT2a and have normal preoperative potency.Asian Journal of Andrology advance online publication, 27 May 2013; doi:10.1038/aja.2012.157.
    Asian Journal of Andrology 05/2013; · 2.14 Impact Factor
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    ABSTRACT: PURPOSE: Bladder cancer is one of the world's top ten malignant tumors. The crucial role of microRNA in carcinogenesis has been well emphasized. Considering miRNA expression was tumor stage-, tissue-, or even development-specific, more experimental evidences about the functions of miRNAs in bladder cancer should be discovered to advance applying of miRNA in the diagnosis or therapy of cancer. METHODS: MiR-708 level in bladder carcinoma and adjacent noncancerous tissues was tested by real-time qPCR. Cell apoptosis was analyzed by using flow cytometry. The tumorigenicity of bladder carcinoma cells was evaluated in nude mice model. Luciferase reporter gene assays were performed to identify the interaction between miR-708 and 3'UTR of Caspase-2 mRNA. The protein level of Caspase-2 was determined by western blotting. RESULTS: In this study, we reported that miR-708 was frequently dysregulated in human bladder carcinoma tissues compared to normal tissues. In addition, we found that silencing of miR-708 could promote the T24 and 5637 cells to apoptosis and inhibit the bladder tumor growth in vivo. Also, Caspase-2 was proved to be one of direct targets of miR-708 in T24 and 5637 cells. Further results showed that Caspase-2 was involved in the miR-708 regulated cell apoptosis. CONCLUSIONS: All together, these results suggest miR-708 may act as an oncogene and induce the carcinogenicity of bladder cancer by down-regulating Caspase-2 level.
    Journal of Cancer Research and Clinical Oncology 04/2013; · 2.91 Impact Factor
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    ABSTRACT: Objectives. To introduce a low-cost, self-made device for single-port retroperitoneal laparoscopic radical nephrectomy and to evaluate outcomes compared with conventional laparoscopy after initial experience using this device. Methods. Twenty-nine renal cancer patients underwent retroperitoneal laparoendoscopic single-site radical nephrectomy using a self-made single-port device with multiple manipulation channels for passage of routine laparoscopic instruments and specimen removal. A control group of 29 patients who were matched by age, gender, and cancer stage underwent conventional laparoscopy. Outcomes were analyzed retrospectively. Results. There were no significant differences in age, gender, body mass index, T stage, and maximum tumor diameter between groups (P > .05). The laparoendoscopic single-site surgery group had a significantly shorter duration of postoperative hospitalization than the conventional laparoscopy group (7.14 ± 1.38 days vs 8.17 ± 1.54 days, P = .009). Conclusions. Retroperitoneal laparoscopic radical nephrectomy using our self-made single-port device appears to be a feasible, safe, and low-cost surgical strategy.
    Surgical Innovation 12/2012; · 1.54 Impact Factor
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    ABSTRACT: The oncological and functional results of 329 cases in a population treated with extraperitoneal laparoscopic radical prostatectomy (ELRP) were evaluated retrospectively. A total of 329 inconsecutive patients with prostate cancer (PCa) who underwent ELRP were retrospectively analyzed. The median initial prostate-specific antigen (PSA) level was 17.35 ng/ml. The median biopsy Gleason score was 7.77. Patients with a T2 or T3a clinical stage had received preoperative neoadjuvant hormonal therapy (NHT) for 3 to 9 months prior to ELRP. No conversion or re-intervention were observed. The median time for anastomosis, surgery time and postoperative catheterization time were 13.0 min, 90.0 min and 6 days, respectively. The median estimated blood loss was 75 ml. There were 12 temporary urinary leakages requiring prolonged catheterization to 14 days. There was 1 case of deep vein thrombosis, 1 case of alimentary tract hemorrhage and 7 cases of anterior urethral stricture. The median follow-up time was 27 months. A total of 17 patients were lost during the follow-up period. No rectal injury, lymphocele, incision hernia, postoperative persistent urinary leak or anastomotic stricture occurred. Younger patients (≤67 years of age) had a more rapid recovery of continence and a better postoperative potency. The overall positive surgical margin rate was 16.7%, which correlated with the pathological stage and Gleason score, respectively (both P<0.001). A total of 89 (28.6%) patients were diagnosed with biochemical recurrence. The initial PSA value, PSM, pathological stage and Gleason score were identified as independent prognostic factors for biochemical recurrence-free survival using multivariate analysis. Our results demonstrated that preoperative NHT had significant effects on the pathological Gleason score (P<0.001) and surgical margin (P=0.027), but no significant impact on biochemical recurrence (P=0.202). The reproducibility of ELRP has been proven as a reliable curative treatment in Western countries during the last 15 years. Due to the increase in PCa patients, the results of our study may aid surgeons who use ELRP for the first time.
    Oncology letters 08/2012; 4(2):351-357. · 0.24 Impact Factor
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    ABSTRACT: Abstract Purpose: The purpose of this study was to introduce a new method for locating the renal artery during retroperitoneal laparoscopic renal surgery. Patients and Methods: The medial arcuate ligament (MAL) is a tendinous arch in the fascia under the diaphragm, which arches across the psoas major muscle and is attached medially to the side of the first or the second lumbar vertebra. The renal artery arises at the level of the intervertebral disc between the L1 and L2 vertebrae. We evaluate the role of the MAL that serves as an anatomic landmark for locating the renal artery during retroperitoneal laparoscopic renal surgery. Results: There is a reproducible consistent anatomic relationship between MAL and the renal artery in 210 cases of retroperitoneal laparoscopic renal surgery. Two main types of the MAL, the "narrow arch" and the "fascial band" types, can be observed. Conclusions: MAL can serve as an accurate and reproducible anatomic landmark for the identification of the renal artery during retroperitoneal laparoscopic renal surgery.
    Journal of endourology / Endourological Society 07/2012; · 1.75 Impact Factor
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    ABSTRACT: Laparoscopic adrenalectomy has become the gold-standard for the surgical treatment of most adrenal lesions. This study evaluated the operative outcome of laparoendoscopic single-site (LESS) retroperitoneoscopic adrenalectomy (LESS-ARA) in comparison with the current standard operation procedure. Between June and December 2009, 19 patients underwent LESS-ARA, and their outcomes were compared with a contemporary 1:2 matched-pair cohort of 38 patients who underwent standard ARA by the same surgeon. In LESS-ARA, a multichannel port was inserted through a 2.5- to 3.0-cm transverse skin incision below the tip of the 12th rib. The LESS-ARA procedure was performed using a 5-mm 30º laparoscopic camera and two standard laparoscopic instruments. The following parameters were compared between the two groups: demographics, details of the surgery, perioperative complications, postoperative visual analog pain scale score, analgesic requirement, and short-term measures of convalescence. The finding showed that LESS-ARA and standard ARA were comparable in terms of the estimated blood loss (30 vs 17.5 ml; p=0.64), postoperative hospital stay (6 vs 6 days; p=0.67), and postoperative complications (2 vs 3 patients; p=1.00) for patients with similar baseline demographics and median tumor size (2.1 vs 3.0; p=0.18) cm. The intraoperative hemodynamic values were similar in the two groups. The LESS-ARA group had a longer median operative time (55 vs 41.5 min; p=0.0004), whereas the in-hospital use of analgesics was significantly less (5 vs 12 morphine equivalents; p=0.03). The LESS retroperitoneoscopic adrenalectomy approach is feasible and offers a superior cosmetic outcome and better pain control, with perioperative outcomes and short-term measures of convalescence similar to those of the standard approach, albeit with a longer operative time.
    Surgical Endoscopy 07/2011; 25(7):2117-24. · 3.43 Impact Factor
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    ABSTRACT: Systemic chemotherapy is the only current modality that provides the potential for long-term survival in bladder carcinoma patients with metastatic disease. Overexpression of cyclooxygenase-2 COX-2 induces expression of immune- and cell proliferation-related genes and is associated with the grade, prognosis and recurrence of transitional cell carcinoma of the bladder. There is abundant evidence that aberrant expression of microRNAs (miRNAs) is implicated in numerous disease states and miRNAs have the potential to be used for cancer therapeutics. Here, we found expression of miR-143 to be low in a series of human bladder carcinomas as compared to background tissue. In addition, restoration of miR-143 by cell transfection in T24 cancer cells led to decreased COX-2 expression, reduced proliferation and mobility. Our findings will help to further understand the functions of miRNAs in cancer cells and point to a specific potential of miR-143 may be employed as a therapeutic agent for bladder carcinoma. The results provide insights into the development of novel tumor markers or new therapeutic strategies.
    Asian Pacific journal of cancer prevention: APJCP 01/2011; 12(4):929-33. · 1.50 Impact Factor
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    ABSTRACT: Hypoxia-inducible factor-1alpha (HIF-1a) is widely considered to be one of the key regulators in cancer cells. Here, we investigated a microRNA regulating expression of HIF-1a and explored its functions in clear cell renal cell carcinoma (ccRCC) cells. Western blot and reporter assays were used to assess HIF-1a as a direct target of miR-138. The effects of miR-138 or si-HIF-1a on ccRCC 786-O cells were also estimated by apoptosis analysis and cell migration assay. The data showed HIF-1a to be one target of miR-138. Futhermore, inhibition of the expression of HIF-1a with specific siRNA or miR-138 could increase apoptosis and reduce the migration of 786-O cells. miR-138 could inhibit the expression of HIF-1a and regulate the apoptosis and migration of ccRCC cells.
    Asian Pacific journal of cancer prevention: APJCP 01/2011; 12(5):1307-11. · 1.50 Impact Factor
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    ABSTRACT: The urothelial carcinoma is the most common pathological type of bladder tumor. Creation of lists of miRNAs differentially expressed between this tumor type and normal tissue might help identify new diagnostic and prognostic markers. We therefore performed the present miRNA microarray analysis with 25 cases of bladder urothelial carcinomas and adjacent normal bladder tissue. The results showed a panel of 51 differentially expressed miRNAs with at least 2-fold differences in expression compared with the normal controls, including 20 up-regulated and 31 down-regulated examples. The expression levels of ten of the top dysregulated miRNAs, mir-1, mir-145, mir-143, mir-100, mir-200b, mir-708, mir-133a, mir-133b, mir-125b and mir-99 were experimentally verified using real-time RT-PCR analysis. These findings suggest that these miRNAs may be involved in bladder urothelial carcinoma pathogenesis and have potential as biomarkers.
    Asian Pacific journal of cancer prevention: APJCP 01/2010; 11(4):905-11. · 1.50 Impact Factor
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    ABSTRACT: To investigate a novel and effective method to occlude the inferior vena cava (IVC) during surgical management of a renal tumor with a tumor thrombus extension into the IVC. We retrospectively reviewed the records of 10 patients with renal cell carcinoma or renal angiomyolipoma with tumor thrombus extending into the IVC who had undergone surgical intervention at our institute from May 2005 to May 2006. The balloon occlusion of the IVC was performed during surgery to decrease the risk of pulmonary embolism. One patient could not tolerate the test occlusion of the IVC and the procedure was converted to IVC-right atrium bypass. The remaining 9 patients successfully underwent nephrectomy and thrombectomy with the help of temporary balloon obstruction of the IVC without perioperative mortality or morbidity. The blood pressure and circulatory status were stably maintained during occlusion of the IVC. Temporary balloon occlusion of the IVC is a simple and reliable technique that decreases the risk of pulmonary embolism and facilitates the resection of renal tumor with levels II and III IVC thrombus.
    Urology 02/2009; 73(3):645-8. · 2.42 Impact Factor
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    ABSTRACT: To investigate the role of the tumor suppressor gene BRCA1 in response to DNA damage and to confirm that the function of the BRCA1 protein is regulated by a variety of mechanisms including transcriptional control, phosphorylation and protein-protein interaction. With the human breast cell line MCF7 as the positive control, we determined the subcellular distribution of BRCA1 in the prostate cancer cell lines LNCaP, DU145 and PC3 by immunohistochemical staining and Western blotting analyses. BRCA1 was present in the prostate cancer cell lines LNCaP, DU145 and PC3. Ionizing radiation induced BRCA1 nuclear export, increasing from 14% to 40% in the cytoplasma (P < 0.01) and decreasing from 46% to 21% in the nuclei (P < 0.01). This DNA damage-induced BRCA1 nuclear export occurred only in the p53 wild-type but not in the p53 mutant cell line. The apoptosis rate of LNCaP cells was as high as 40% after nuclear export, with an obvious increase of cleaved caspase-3, which was correlated with BRCA1 nuclear-cytoplasmic shuttling. Cytoplasmic relocalization of the BRCA1 protein may be a mechanism whereby the BRCA1 function is regulated in response to DNA damage. Its induction of a higher rate of cell apoptosis indicates BRCA1 to be another good biomarker for the treatment of prostate cancer.
    Zhonghua nan ke xue = National journal of andrology 09/2008; 14(8):685-9.
  • Asian Journal of Andrology 04/2008; 10(2):341-2. · 2.53 Impact Factor
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    ABSTRACT: To assess the clinical efficacy and safety of photoselective laser vaporization of the prostate (PVP) in the treatment of patients with acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH). Forty-two patients (mean age 72 +/- 5 years, range 65-89) with AUR because of BPH were treated with a prospective trial of PVP with the potassium-titanyl-phosphate (KTP) laser. The treatment outcome was evaluated with subjective and objective tests at 1, 3, 6, and 12 months after PVP using the International Prostate Symptom Score (IPSS), disease-specific quality of life (QoL) score, postvoid residual (PVR) urine volume, and maximum urinary flow rate (Qmax). The International Index of Erectile Function questionnaire and a self-designed ejaculatory questionnaire were completed at different follow-up times to determine patient satisfaction and changes in sexual function. After preliminary urine drainage and adequate preoperative preparation, PVP was performed and bladder outlet obstruction was effectively relieved. The mean prostate volume was 62.5 +/- 11.7 cc, and the mean residual volume with retention was 650 mL (range 240-1200 mL). Mean operative time was 28.6 +/- 5.7 minutes. Mean catheterization duration was 5.6 days (range 3-14 d). There was significant subjective improvement of symptoms and objective improvement in urinary flow rates at 12 months. The mean IPSS and QoL score decreased significantly (P < 0.05). Mean PVR volume also decreased. The mean Qmax was 16.2 +/- 4.6 mL/sec after treatment. Only two patients had recurrent urinary retention during follow-up. There were no intraoperative or postoperative adverse events. The early clinical results suggest that the PVP is a promising safe, effective, and less-invasive treatment with minimal morbidity for patients with urine retention secondary to BPH.
    Journal of Endourology 03/2008; 22(3):539-43. · 2.07 Impact Factor
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    ABSTRACT: To study the expression of Livin, an apoptosis inhibitor gene, in prostate cancer, and to investigate its clinical and pathological implications. The expressions of Livin were detected in 62 cases of neoplastic prostate tissues and 10 cases of normal prostate tissues by RT-PCR and immunohistochemistry (SP method). The Livin gene was highly expressed in neoplastic prostate tissues, but not in normal ones. Positive expression of Livin proteins was observed in 37 of the 62 (59.7%) tumor samples and accounted for 28.6%, 60.0% and 83.3% in the high, middle and low differentiation prostatic carcinoma groups respectively, with significant difference between the high and low groups. Livin positivity was also significantly correlated with tumor stages, increasing with tumor progression. Livin may play an essential role in prostate carcinogenesis and serve as a marker for the prognosis of prostate cancer.
    Zhonghua nan ke xue = National journal of andrology 02/2008; 14(1):30-3.
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    ABSTRACT: To study the expression of Livin, an apoptosis inhibitor gene, in bladder transitional cell carcinoma (TCC), and to investigate its clinical and pathological implications. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was used to detect the expression of Livin in the tissues of TCC, 21 among them being recurrent carcinoma, obtained during operation from 60 cases, 48 males and 12 females, aged 58.6 (34 approximately 85), and 10 samples of tissues far from the TCC from the 60 cases. The overall positive rate of Livin in the 60 cases of TCC was 28.3% (17/60), and was 0 in the 10 cases of tissues far from the TCC. The Livin positivity was not correlated with tumor stage and grade (both P > 0.05). The positive rate of the recurrent bladder carcinoma was 38.1% (8/21), higher than that of the primary bladder carcinoma (23.1%, 9/39), however, not significantly (P > 0.05). Livin may play an essential role in bladder carcinogenesis and serve as a marker for prognosis of bladder carcinoma.
    Zhonghua yi xue za zhi 03/2007; 87(12):806-7.
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    ABSTRACT: To assess the clinical efficacy and safety of photoselective vaporization of the prostate (PVP) in the treatment of patients with acute urinary retention, secondary to benign prostatic hyperplasia (BPH). Patients and Methods: Thirty-two patients with acute urinary retention due to BPH were treated with the green-light laser, in a prospective trial. The treatment outcome was evaluated using the International Prostate Symptom Score (IPSS), diseasespecific quality of life (QoL) score, postvoiding residual urine volume and maximum urinary flow rate (Qmax). Followup assessment and sexual function were performed immediately postoperatively and at 3, 6 and 12 months. Results: The mean patient age was 72 � 5 years (range 65-89 years). The mean residual volume presenting with retention was 350 ml (range 240-1,200ml). The mean operating time was 48.6 � 5.7 min. The mean catheterization duration after the operation was 5.6 days (range 3-14 days). The mean IPSS and QoL decreased significantly from 22.5 � 4.6 and 5.3 � 1.2 to 8.4 � 5.6 (p = 0.01) and 1.8 � 1.2 (p = 0.03), respectively. The mean residual volume decreased to 58 ml, the mean Qmax was 16.2 � 4.6 ml/s after treatment. Only 2 patients had recurrent urinary retention during follow-up. Conclusions: The early clinical results suggest that PVP is a promising safe, effective and less-invasive treatment for high-risk patients with urine retention secondary to BPH.
    Current Urology. 01/2007; 1(1):35-38.
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    ABSTRACT: We evaluated 3-D computed tomography angiography (3-D CTA) in the diagnosis of the nutcracker phenomenon, and its significance in postoperative follow up. Three-dimensional CTA was used to compare the anatomical relations of the left renal vein with the aorta and the superior mesenteric artery in patients with the nutcracker phenomenon and in a control group. Four patients with the nutcracker phenomenon received a surgical procedure of the transposition of the left renal vein. The 3-D CTA was used for all patients during postoperation follow-up testing. The 3-D CTA showed a compression of the left renal vein between the aorta and the superior mesenteric artery (SMA) and the abnormal acute angle between them. The angles and distances between the SMA and the aorta were 39.3 +/- 4.3 degrees and 3.1 +/- 0.2 mm in the patient groups and 90 +/- 10 degrees and 12 +/- 1.8 mm in the control groups, respectively. Differences in angles and distances were statistically significant between the two groups (P < 0.05). Surgical transposition of the left renal vein was performed successfully. Postoperative 3-D CTA revealed the distance between the SMA and the aorta was nearly normal. The reconstruction imaging of the renal vein by means of 3-D CTA revealed that unusual hematuria was due to compression of the left renal vein; therefore it may be a useful alternative imaging technique instead of conventional examinations. The non-invasive 3-D CTA may be a useful tool in the diagnosis of the nutcracker phenomenon and follow-up testing.
    International Journal of Urology 07/2006; 13(7):870-3. · 1.73 Impact Factor

Publication Stats

134 Citations
33.82 Total Impact Points

Institutions

  • 2005–2014
    • 307 Hospital of the Chinese People's Liberation Army
      Peping, Beijing, China
  • 2005–2013
    • Chinese PLA General Hospital (301 Hospital)
      Peping, Beijing, China